10-1012 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
1 10-000010123
Property Address:
�\ 46422 BRADSHAW TR
APN:
643-170-999-52 -31348 -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
18000
Tu�v 4 4 Q"
Applicant: Architect or Engineer:
�fj,4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
---------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION -
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C53 License No.: 816170
/bete: Ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the .
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractorW licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
GLOBAL INVESTMENTS
3470 WILSHIRE BLVD. #1020
LOS ANGELES, CA 90010
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/28/10
Contractor: Lj!r`.! Ll '
INDIO HILLS POOL C RUCTION 1!I
28800 DESERT CHARMJ O� 1lII
DESERT HOT SPRINGS 92042 I 131 2 10 P L/
(760)393-6720
LiC. NO.: 816170 y' `r3 ti;iilih
------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Y I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 0004052-2009
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of th Labor Code, I shall forthwith comply with th rovisions.
IV
ate: ( plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAG�ISLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000)• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
0Lthisl1county to enter upo the above-mentioned property for ins fiction purposes.
Date: l� nature (Applicant or Agent): �Ai
Application Number . . . . . 10-00001012
Permit BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 189.00 Plan Check Fee 122.85
Issue Date . . . . Valuation 18000
Expiration Date 3/27/11
Qty Unit Charge Per Extension
BASE FEE 45.00
16.00 9.0000 THOU BLDG 2,001-25,000 144.00
----------------------------------------------------------------------------
Permi t . . . MECH POOL
Additional desc . .
Permit Fee . . . 26.00
Issue Date . . . .
Expiration Date . . 3/27/11
Plan Check Fee 6.50
Valuation' 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
----------------------------------------------------------------------------
Permit ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee .
Issue Date . . . . Valuation
Expiration Date . . 3/27/11
11.25
0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 30..0000 EA ELEC PRIVATE SWIMMING POOL 30.00
----------------------------------------------------------------------------
Permit PLUMBING
Additional desc . .
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Expiration Date . 3/27/11
Qty
Unit Charge Per
Extension
BASE
FEE
15.00
2.00
6.0000 EA,
PLB
FIXTURE
12.00
1.00
3.0000 EA
PLB
WATER INST/ALT/REP
3.00
1.00
3.0000 EA
PLB
GAS PIPE 1-4 OUTLETS
3.00
--------------------------7--------------------I-----------------------------
Special Notes and Comments
POOL/SPA.
ALARMS/BARRIERS
SHALL
BE IN
LQPERMIT
Application Number . . . . . 10-00001012
----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2007
CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged
--------------------
Paid
Credited
--------------------
Due
*Permit Fee Total
293.00
.00
.00
293.00
Plan Check Total
148.85
.00
.00
148.85
Other Fee Total
1.00
.00
.00
1.00
Grand Total.
442.85
.00
.00
442.85
LQPERMIT
4
AC
P/L
P/L
INDIO HILLS POOL CONSTRUCTION
28-800 DESERT CHARM RD
INDIO HILLS CA. 92241.
BUS.PHONE#(760) 342-3246 CELL (760)393-6720
CA. LIC.#816170 C-53
EQUIPMENT
* 1- Hayward multi speed pump circulation pump
* 1- 325 cfm Hayward cartridge Filter
* 1-400,000 btu Hayward heater
ft. 6 in * 1- 400w pool light 1 100w for spa light
*I - pro -logic system.
* auto fill device
5 ft.
*3- 12" sheer descent
P/L
Bin #
City of La Quinta
Bedding 8t Safety Dhrfsion
P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
Building Pennit Application and Tracking She;al
I
Penna' #
„ l
1
Project Address: Z�l� —ya
A. P. Number:
('Q 6� W ")f'
Owncr's Name:
Address. t. o
i� C
{
Legal Description:
'
City, ST, Zip:-
I
Contractor. ( j Q� f
Address:O-Nm Tfyf
Telephone:
Project Description:
City, ST, Zip (a
Telephone: _70 3/; —cP W
State Lic. # : g / `p / ��
City Lic. C. ?j 7 ,p 9
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lia #:
Name of Contact Person:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Pian Sets
Plan Check submitted
Item
Amount
Structural Cafes
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Pian Check Balance
Tule U Calca.
Plans picked up
Construction
Flood plain pian
Plana resubmitted
Mechanical
Grading plan
21' Review, ready for corrtctionsibsae
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
7